Gender and Population Studies (GAPS) in Health

Supporting Successful Transplantation (SST) Tool

Welcome! We are glad you are interested in the SST tool. The tool emerged from research with newcomers to Southern Alberta, which focused on their migration experiences, mental health challenges, and exploration of coping strategies.  One of our participants talked about feeling like a “branch without a tree” and this was the start of further conversations about the tree being an apt metaphor for migration experiences.  It is our intention that the metaphor and visuals of the tree within the SST package can be used to help bridge language barriers and to facilitate a discussion about where a newcomer is on their journey, including their current struggles and resources.

Download a the Presentation that the Research Team Made to the October 2024 Metropolis Identities and SDH Conference in Vancouver, B.C., Canada.

Get a PDF Version of the SST Tool

Get at PDF of the SST User Guide

Download a the Presentation that the Research Team Made to the October 2024 Metropolis Identities and SDH Conference in Vancouver, B.C., Canada.

The tree represents the newcomer and migration is represented by the uprooting and transplantation of the newcomer (tree) to a new home. With this uprooting, they are often exposed to very different climatic and soil conditions than those experienced previously. The migrant must adapt to these new and changing conditions to achieve successful transplantation, new and continued growth, and success in their new home. There are many internal (to the newcomer) and external factors that influence how successful this transplantation and journey of growth might be, and this tool was created to assist service providers in identifying the unique factors that are influencing their newcomer clients.

Based on the input of our research participants and stakeholders, we recommend emphasising the newcomer’s strengths throughout the process of meeting and working with them. For some, it may be helpful to say (or with use of translator), “you have shown strength and resilience like a tree by making it here and beginning to put down new roots” when sharing the SST visual tool.

We envision using the tool in a relational way with newcomers and encouraging them to be active participants in co-creating the tree visual with you as practitioner. Rather than the typical practice of a person in a position of power (e.g. a service provider) completing a form by asking pre-established questions and filling in the answers, this relational approach invites the client to be a collaborative participant in the assessment of their current situation, the identification of both challenges and strengths and the prioritization of their immediate needs. This process may foster a greater sense of personal power and agency in the client.

The participants in our research emphasized the need for clear and culturally sensitive processes when interacting with our host healthcare system and social services providers. With this in mind, we developed the SST worksheet (with feedback from newcomer participants and those currently working with newcomers) for ease of use while also acknowledging that newcomers’ experiences are diverse and that not every nuance of each unique person will be captured. 

Below we will dive into the various elements of the SST tool and how to use it to assist newcomers in an effective way.

Feeling Faces – these are universal symbols that match a basic range of emotions.

We suggest asking the newcomer to choose the best face to show how they are feeling in this moment in meeting you/talking to you. We also recommend asking them to identify how they have been feeling generally over the course of their arrival to Canada.

Tree Trunk – Current State – These three boxes are to record the top three challenging things the newcomer client is dealing with at present.

The newcomer client may come to the meeting with some priority needs or issues that they wish to seek help for, or the provider completing the process may wish to engage the client in a discussion surrounding their current challenges, and collaboratively determine which are the most immediate or important to the client. Therefore, completing the page on identifying challenges (see #6 below) prior to identifying the top three may be a beneficial approach.

Rooting in Rocky Soil – Identify the three priority settlement climate challenges that are impacting the client’s successful transplantation.

In collaboration with the newcomer client, identify their primary challenges in their settlement journey that are impacting their ability to put down roots and establish a foundation for success and putting down new roots (e.g., English language competency, affordable housing, or poor recognition of prior education and work experience could serve as proverbial rocks to navigate as they settle in their new home). Similarly, completing the page identifying challenges (see #6 below) prior to identifying the top three barriers in the settlement climate may be a beneficial approach.

*Note that there may be some crossover between the current challenges that are identified on the tree trunk or current state and the more historical or long view challenges from the migration journey.

Successful Rooting – Identify the three key strengths or supports that are helping the newcomer to put down roots in their new home.

In collaboration with the newcomer client, identify the key factors in their settlement climate that are supporting them to put down roots and succeed in their new home (e.g., Their local friends and family, the settlement agency staff or programs, the support of their immigrant association, or their ESL class may serve as things that nurture their successful transplantation).

Resources – That newcomers possess within themselves, bring with them, or have access to in their new home.

Newcomers do not arrive as a blank slate, they have skills, abilities, education, experience, and so much more that they bring to their new home. They are also part of communities of other newly transplanted newcomers, who may provide support and shelter from adverse climatic conditions and the winds of adversity.

This page provides an opportunity to collaboratively identify, document, and celebrate the resources they have and to take a strengths-based approach to addressing any arising challenges in their path forward towards successful transplantation. These resources are analogous to the existing root structure, branches and leaves that the newcomer tree can lean on as they expand their roots and create new growth in a new location, or to the support and shelter that a newly transplanted tree might get from other trees surrounding it.

Challenges – Navigating a new location, climate, and conditions are bound to create some challenges or barriers that will need to be overcome on the way to successful transplantation.

This page provides an opportunity to collaboratively identify the challenges that a newcomer client is currently facing in their new environment, and to prioritize the role that each of these challenges is playing on their path to successful transplantation.

As we have heard time and again from our research participants and stakeholders, challenges often intersect with each other to impact the client’s reality. This is analogous to how branches become twisted and damaged in response to intersecting challenging conditions such as drought, soil with low nutrient content, severe winter conditions, high winds, or fungal infection. The provider may choose to rank each of these identified challenges with input from the client (e.g. assigning a 1 to the biggest challenge from the client’s perspective, with decreasing impact as the numbers get larger). While all challenges may need to be addressed over time, this process can help the provider to collaboratively create a plan with the newcomer client to address these challenges in relation to what is considered a priority from the client’s perspective.

We encourage service providers’ common practice of having resources on hand to address challenges that require immediate action – such as reported mental health crises, housing needs, and health appointments. Some of these resources may count as either challenges or strengths when working collaboratively with the newcomer client. Newcomer research participants highlighted the significance of service providers avoiding assumptions about the helpfulness of a resource. They stressed the need for providers to actively inquire about the participants’ past experiences with specific resources.

Collectively, completing this tool will identify on the first page the key issues a newcomer client is currently dealing with, and detailed information about the challenges the newcomer is facing, and the strengths they possess that can be leaned on in addressing these challenges. It can serve to facilitate a complex exploration of a newcomer’s reality and needs for health care providers, a settlement practitioner, or a counsellor/therapist to work with a newcomer client. It can also inform a collaborative planning process to address these key challenges, while also celebrating the strengths and resilience that each newcomer possesses, rather than focusing purely on difficulties and what is lacking.

Acknowledgements

This tool was developed by Dr. Toupey Luft and Dr. Peter Kellett based on the findings from their Prentice Institute for Global Population and Economy funded project entitled “Gender, Migration, and Mental Health Support Needs among Immigrants to Southern Alberta